Endocrinology, Diabetes and Metabolism最新文献_第5页

Immune Checkpoint Inhibitors-Induced Endocrinopathies: Assessment, Management and Monitoring in a Comprehensive Cancer Centre 免疫检查点抑制剂诱发的内分泌病：综合癌症中心的评估、管理和监测。

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-06-26 DOI: 10.1002/edm2.505

Omayma Elshafie, Abir Bou Khalil, Bushra Salman, Abier Atabani, Hasan Al-Sayegh

Objectives

To determine the incidence, presentation, frequency and management of immune checkpoint inhibitors (ICI)-related endocrinopathies in a comprehensive cancer centre in Oman, particularly with programme death 1/programme death-ligand 1 (PD-1/PD-L1) inhibitors.

Background

A high number of patients treated with PD-1/PD-L1 inhibitors for the management of solid tumours developed endocrinopathies.

Methods

This is a retrospective study of patients admitted to Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC) from August 2021 to December 2022. All adults diagnosed with solid cancers and have received at least one dose of ICIs were included. Patients with incomplete data were excluded from the analysis. Data regarding the ICI-induced endocrinopathy were collected.

Results

A total of 139 patients were included in the study of which 58% were females. The median age of the cohort was 56 years. The incidence of endocrine-related adverse events was 28%. The mean time for the development of endocrine adverse events after treatment initiation was 4.1 ± 2.8 months. Of the patients who developed toxicity, 90% had hypothyroidism. Ten patients developed hyperthyroidism, two patients were diagnosed with secondary adrenal insufficiency/hypophysitis and one patient developed Type 1 diabetes mellitus (DM). Using univariable logistic regression weight and body mass index (BMI) significantly impacted the development of endocrine immune-related adverse events (irAEs).

Conclusions

This is the first study from the Sultanate of Oman to assess PD-1/PDL-1 ICI-induced endocrinopathies. The most common endocrine adverse event is thyroid dysfunction, mainly hypothyroidism followed by hyperthyroidism. Hypophysitis, primary adrenal insufficiency and CIADM occur less frequently, but have a more significant effect on the patient's health. The treating physician should be aware of ICI-induced endocrinopathies, screening and treatment. Furthermore, our study showed that patients with a higher BMI have a greater risk of developing irAES. Further studies are needed to establish the predictors of endocrine irAEs.

目的目的：确定阿曼一家综合癌症中心与免疫检查点抑制剂（ICI）相关的内分泌病的发病率、表现、频率和管理，尤其是与方案死亡1/方案死亡配体1（PD-1/PD-L1）抑制剂相关的内分泌病：背景：大量接受PD-1/PD-L1抑制剂治疗的实体瘤患者出现了内分泌病：这是一项回顾性研究，研究对象为2021年8月至2022年12月期间入住苏丹卡布斯综合癌症护理与研究中心（SQCCCRC）的患者。所有确诊为实体瘤并接受过至少一剂 ICIs 治疗的成人患者均被纳入研究范围。数据不完整的患者被排除在分析之外。收集了有关 ICI 引起的内分泌病变的数据：研究共纳入139名患者，其中58%为女性。组群的中位年龄为 56 岁。内分泌相关不良事件的发生率为 28%。开始治疗后出现内分泌不良反应的平均时间为 4.1±2.8 个月。在出现毒性反应的患者中，90%患有甲状腺功能减退症。10名患者出现甲状腺功能亢进，2名患者被诊断为继发性肾上腺功能不全/肾上腺皮质炎，1名患者出现1型糖尿病（DM）。通过单变量逻辑回归，体重和体重指数（BMI）对内分泌免疫相关不良事件（irAEs）的发生有显著影响：这是阿曼苏丹国第一项评估PD-1/PDL-1 ICI诱发的内分泌病的研究。最常见的内分泌不良事件是甲状腺功能障碍，主要是甲状腺功能减退，其次是甲状腺功能亢进。肾上腺皮质功能减退症、原发性肾上腺功能不全和CIADM发生率较低，但对患者健康的影响更大。主治医生应了解 ICI 引起的内分泌疾病、筛查和治疗。此外，我们的研究还表明，体重指数（BMI）较高的患者发生虹膜异位症的风险更大。要确定内分泌虹膜睫状体异常的预测因素，还需要进一步的研究。

{"title":"Immune Checkpoint Inhibitors-Induced Endocrinopathies: Assessment, Management and Monitoring in a Comprehensive Cancer Centre","authors":"Omayma Elshafie, Abir Bou Khalil, Bushra Salman, Abier Atabani, Hasan Al-Sayegh","doi":"10.1002/edm2.505","DOIUrl":"10.1002/edm2.505","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To determine the incidence, presentation, frequency and management of immune checkpoint inhibitors (ICI)-related endocrinopathies in a comprehensive cancer centre in Oman, particularly with programme death 1/programme death-ligand 1 (PD-1/PD-L1) inhibitors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A high number of patients treated with PD-1/PD-L1 inhibitors for the management of solid tumours developed endocrinopathies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a retrospective study of patients admitted to Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC) from August 2021 to December 2022. All adults diagnosed with solid cancers and have received at least one dose of ICIs were included. Patients with incomplete data were excluded from the analysis. Data regarding the ICI-induced endocrinopathy were collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 139 patients were included in the study of which 58% were females. The median age of the cohort was 56 years. The incidence of endocrine-related adverse events was 28%. The mean time for the development of endocrine adverse events after treatment initiation was 4.1 ± 2.8 months. Of the patients who developed toxicity, 90% had hypothyroidism. Ten patients developed hyperthyroidism, two patients were diagnosed with secondary adrenal insufficiency/hypophysitis and one patient developed Type 1 diabetes mellitus (DM). Using univariable logistic regression weight and body mass index (BMI) significantly impacted the development of endocrine immune-related adverse events (irAEs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is the first study from the Sultanate of Oman to assess PD-1/PDL-1 ICI-induced endocrinopathies. The most common endocrine adverse event is thyroid dysfunction, mainly hypothyroidism followed by hyperthyroidism. Hypophysitis, primary adrenal insufficiency and CIADM occur less frequently, but have a more significant effect on the patient's health. The treating physician should be aware of ICI-induced endocrinopathies, screening and treatment. Furthermore, our study showed that patients with a higher BMI have a greater risk of developing irAES. Further studies are needed to establish the predictors of endocrine irAEs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11208163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Antibiotic Stewardship in the Management of Infected Diabetic Foot Ulcer Disease in Less Developed Countries 欠发达国家在管理感染性糖尿病足溃疡病时的抗生素管理措施

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-06-25 DOI: 10.1002/edm2.503

Zulfiqarali G. Abbas, Raidah R. Gangji, Ilker Uçkay

Background

Diabetic foot ulcers in developing countries often become infected. The healthcare systems are often not equipped to conduct the culture and the sensitivity tests required for prescribing a targeted antibiotic treatment for diabetic foot infection (DFI).

Methods

We evaluate antibiotic stewardship programmes for DFIs, at every level of health care, with an emphasis on resource-poor settings such as in Africa.

Results

The management of DFI very often is adapted to the financial and practical realities of the resource-poor regions. The application of the point-of-care Gram stain of deep tissue samples is efficient, rapid, low cost and ubiquitously available. Upon the identification of the predominant pathogen in the Gram stain, a semi-quantitative preemptive antibiotic treatment can be started in accordance with the World Health Organization Aware, Watch and Restrict Essential Medicine List. This list is catered to every country and is a powerful tool. However, some basic knowledge of the local microbiological epidemiology is necessary to choose the most appropriate agent. We report our experience on using the rapidly available Gram stain for narrowing the preemptive choice of listed antibiotic agents, as an economic tool for antibiotic stewardship in DFIs.

Conclusions

In the practical and resource-saving management of DFI, the ‘therapeutic’ use of Gram stains is not common in resource-rich countries but should be added to the arsenal of the general efforts for antibiotic stewardship.

背景发展中国家的糖尿病足溃疡经常受到感染。医疗保健系统通常不具备为糖尿病足感染（DFI）开具针对性抗生素治疗处方所需的培养和药敏试验条件。方法我们评估了各级医疗机构针对糖尿病足感染的抗生素管理计划，重点是非洲等资源匮乏地区。结果 DFI 的管理往往要适应资源贫乏地区的财政和实际情况。对深层组织样本进行床旁革兰氏染色是一种高效、快速、低成本且普遍可用的方法。一旦在革兰氏染色中确定了主要病原体，就可以根据世界卫生组织的 "认识、观察和限制基本药物清单 "开始半定量的先期抗生素治疗。这份清单适用于每个国家，是一个强有力的工具。不过，要选择最合适的药物，还需要对当地的微生物流行病学有一些基本了解。我们报告了使用快速获得的革兰氏染色法缩小清单所列抗生素药剂的先期选择范围的经验，以此作为发展中金融机构抗生素管理的经济工具。结论在切实可行、节省资源的 DFI 管理中，革兰氏染色法的 "治疗性 "使用在资源丰富的国家并不常见，但应纳入抗生素监管的总体工作中。

{"title":"Antibiotic Stewardship in the Management of Infected Diabetic Foot Ulcer Disease in Less Developed Countries","authors":"Zulfiqarali G. Abbas, Raidah R. Gangji, Ilker Uçkay","doi":"10.1002/edm2.503","DOIUrl":"https://doi.org/10.1002/edm2.503","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diabetic foot ulcers in developing countries often become infected. The healthcare systems are often not equipped to conduct the culture and the sensitivity tests required for prescribing a targeted antibiotic treatment for diabetic foot infection (DFI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We evaluate antibiotic stewardship programmes for DFIs, at every level of health care, with an emphasis on resource-poor settings such as in Africa.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The management of DFI very often is adapted to the financial and practical realities of the resource-poor regions. The application of the point-of-care Gram stain of deep tissue samples is efficient, rapid, low cost and ubiquitously available. Upon the identification of the predominant pathogen in the Gram stain, a semi-quantitative preemptive antibiotic treatment can be started in accordance with the World Health Organization Aware, Watch and Restrict Essential Medicine List. This list is catered to every country and is a powerful tool. However, some basic knowledge of the local microbiological epidemiology is necessary to choose the most appropriate agent. We report our experience on using the rapidly available Gram stain for narrowing the preemptive choice of listed antibiotic agents, as an economic tool for antibiotic stewardship in DFIs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In the practical and resource-saving management of DFI, the ‘therapeutic’ use of Gram stains is not common in resource-rich countries but should be added to the arsenal of the general efforts for antibiotic stewardship.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.503","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141453546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of the Effect of Pistacia atlantica Oleoresin on Blood Sugar, Pressure and Lipids in Patients With Type 2 Diabetes: A Single-Blind, Placebo-Controlled Trial 评估Pistacia atlantica Oleoresin 对 2 型糖尿病患者血糖、血压和血脂的影响：单盲、安慰剂对照试验。

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-06-16 DOI: 10.1002/edm2.504

Zahra Memariani, Mahin Tatari, Maryam Zahedi, Zahra Hesari, Ali Davarian, Fatemeh Kolangi

Background

Diabetes mellitus (DM) is a chronic metabolic disorder characterised by high blood sugar (BS) levels due to impaired insulin production or insulin resistance. It is a global health concern with significant implications for morbidity and mortality. Persian medicine has long utilised natural remedies, such as Pistacia atlantica Desf., for various diseases. In this randomised clinical trial, the effects of P. atlantica oleoresin in the improvement of lipid profiles, glucose indices and blood pressure (BP) were assessed in patients with Type 2 DM.

Materials and Methods

In this randomised, single-blind, placebo-controlled study, 42 patients with Type 2 DM were randomly allocated to receive either P. atlantica oleoresin or placebo capsule for 3 months. Patients were evaluated prior to and 12 weeks after the beginning of the intervention, in terms of changes in lipid profiles, glucose indices and BP.

Results

After 3 months, the mean BP in patients with DM receiving P. atlantica oleoresin was significantly reduced compared with the baseline (p = 0.001). Also, these changes were significantly higher than those of the control group. The mean of total cholesterol (p = 0.89), low-density lipoprotein (LDL) (p = 0.43) and triglyceride (TG) (p = 0.98) in the intervention group after 3 months was lower than that in the control group, but this difference was not statistically significant.

Conclusion

After 3 months, there was no significant difference between the P. atlantica and control groups in terms of blood sugar and lipid profiles. The mean BP in patients with DM receiving P. atlantica oleoresin was significantly reduced compared with that in the beginning of the study. Also, these changes were significant compared with the control group.

背景：糖尿病（DM）是一种慢性代谢性疾病，其特点是由于胰岛素分泌受损或胰岛素抵抗导致血糖（BS）水平过高。它是一个全球关注的健康问题，对发病率和死亡率有重大影响。长期以来，波斯医学一直利用天然药物，如Pistacia atlantica Desf.，治疗各种疾病。在这项随机临床试验中，评估了 P. atlantica 油树脂在改善 2 型糖尿病患者血脂、血糖指数和血压（BP）方面的效果：在这项随机、单盲、安慰剂对照研究中，42 名 2 型糖尿病患者被随机分配接受蕨麻油树脂或安慰剂胶囊治疗 3 个月。在开始干预前和干预 12 周后，对患者的血脂、血糖指数和血压变化进行评估：结果：3 个月后，接受蕨麻油树脂治疗的糖尿病患者的平均血压与基线相比明显降低（p = 0.001）。此外，这些变化也明显高于对照组。3 个月后，干预组的总胆固醇（p = 0.89）、低密度脂蛋白（LDL）（p = 0.43）和甘油三酯（TG）（p = 0.98）的平均值低于对照组，但差异无统计学意义：结论：3 个月后，干预组和对照组在血糖和血脂方面没有明显差异。与研究开始时相比，接受蕨麻油树脂治疗的糖尿病患者的平均血压明显降低。与对照组相比，这些变化也很明显。

{"title":"Evaluation of the Effect of Pistacia atlantica Oleoresin on Blood Sugar, Pressure and Lipids in Patients With Type 2 Diabetes: A Single-Blind, Placebo-Controlled Trial","authors":"Zahra Memariani, Mahin Tatari, Maryam Zahedi, Zahra Hesari, Ali Davarian, Fatemeh Kolangi","doi":"10.1002/edm2.504","DOIUrl":"10.1002/edm2.504","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diabetes mellitus (DM) is a chronic metabolic disorder characterised by high blood sugar (BS) levels due to impaired insulin production or insulin resistance. It is a global health concern with significant implications for morbidity and mortality. Persian medicine has long utilised natural remedies, such as <i>Pistacia atlantica</i> Desf., for various diseases. In this randomised clinical trial, the effects of <i>P. atlantica</i> oleoresin in the improvement of lipid profiles, glucose indices and blood pressure (BP) were assessed in patients with Type 2 DM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>In this randomised, single-blind, placebo-controlled study, 42 patients with Type 2 DM were randomly allocated to receive either <i>P. atlantica</i> oleoresin or placebo capsule for 3 months. Patients were evaluated prior to and 12 weeks after the beginning of the intervention, in terms of changes in lipid profiles, glucose indices and BP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After 3 months, the mean BP in patients with DM receiving <i>P. atlantica</i> oleoresin was significantly reduced compared with the baseline (<i>p</i> = 0.001). Also, these changes were significantly higher than those of the control group. The mean of total cholesterol (<i>p</i> = 0.89), low-density lipoprotein (LDL) (<i>p</i> = 0.43) and triglyceride (TG) (<i>p</i> = 0.98) in the intervention group after 3 months was lower than that in the control group, but this difference was not statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>After 3 months, there was no significant difference between the <i>P. atlantica</i> and control groups in terms of blood sugar and lipid profiles. The mean BP in patients with DM receiving <i>P. atlantica</i> oleoresin was significantly reduced compared with that in the beginning of the study. Also, these changes were significant compared with the control group.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11180711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Identification of Risk Factors for the Development of Diabetic Retinopathy Among Palestinian Adults With Type 2 Diabetes Mellitus: A Cross-Sectional Study 确定巴勒斯坦 2 型糖尿病成人中发生糖尿病视网膜病变的风险因素：一项横断面研究

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-06-14 DOI: 10.1002/edm2.494

Oadi N. Shrateh, Mohammad Abdelhafez, Suheir Ereqat, Lana Naser El Dein, Salam Iriqat

Introduction

Although risk factors linked to diabetic retinopathy (DR) among patients with Type 2 diabetes mellitus (T2DM) have been extensively studied globally, the specific determinants of these factors in relation to DR in Palestine are presently not well understood.

Methods

This retrospective cross-sectional study included patients who underwent DR screening with a fundus camera (VersaCam a). The study included patients aged ≥18 with T2DM, excluding those with other types of diabetes or a history of malignancies. Univariable and multivariable logistic regressions were used to identify factors associated with DR.

Results

A total of 1163 patients with T2DM were included in this study. Of these, 211 (18.1%) patients were classified in the DR group, 761 (65.4%) in the no DR group and 191 (16.4%) were ungradable. Among the included patients, 434 (37.3%) were male. A secondary level of education or higher and a BMI ≥30 kg/m², compared with <25 kg/m², were independently and inversely associated with DR, with odds ratios (ORs) of 0.46 (p < 0.001) and 0.58 (p = 0.046), respectively. A 5-year increase in the duration of T2DM correlated with 45% higher odds of having DR (p < 0.001). Patients with DR were more likely to have HbA1c >7%, be physically inactive and use insulin, with ORs of 1.63 (p = 0.02), 2.05 (p < 0.001) and 1.53 (p = 0.03), respectively. Age, gender, occupational status, hypertension and hyperlipidaemia were not independent predictors of DR (p < 0.05).

Conclusion

Longer duration of T2DM, HbA1c >7%, physical inactivity and insulin use were all independently associated with the presence of DR. Furthermore, a secondary or higher educational level and obesity demonstrated independent and inverse associations with the development of DR.

导言：尽管全球范围内对 2 型糖尿病（T2DM）患者中与糖尿病视网膜病变（DR）相关的风险因素进行了广泛研究，但目前对这些因素在巴勒斯坦与糖尿病视网膜病变相关的具体决定因素还不甚了解：这项回顾性横断面研究包括使用眼底照相机（VersaCam a）进行 DR 筛查的患者。研究对象包括年龄≥18 岁的 T2DM 患者，不包括患有其他类型糖尿病或有恶性肿瘤病史的患者。采用单变量和多变量逻辑回归来确定与 DR 相关的因素：本研究共纳入了 1163 名 T2DM 患者。其中，211 例（18.1%）患者被归入 DR 组，761 例（65.4%）被归入无 DR 组，191 例（16.4%）无法分级。在纳入的患者中，434 人（37.3%）为男性。中等或更高的教育水平和体重指数≥30 kg/m2（与2相比）与DR独立成反比，几率比（ORs）为0.46（P 7%），不运动和使用胰岛素的几率比（ORs）分别为1.63（P = 0.02）、2.05（P 结论：T2DM持续时间越长、HIV感染率越高，DR的几率比（ORs）就越高：T2DM 病程较长、HbA1c >7%、缺乏运动和使用胰岛素都与 DR 的存在有独立关联。此外，中等或更高的教育水平和肥胖与 DR 的发生呈独立的反向关系。

{"title":"Identification of Risk Factors for the Development of Diabetic Retinopathy Among Palestinian Adults With Type 2 Diabetes Mellitus: A Cross-Sectional Study","authors":"Oadi N. Shrateh, Mohammad Abdelhafez, Suheir Ereqat, Lana Naser El Dein, Salam Iriqat","doi":"10.1002/edm2.494","DOIUrl":"10.1002/edm2.494","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Although risk factors linked to diabetic retinopathy (DR) among patients with Type 2 diabetes mellitus (T2DM) have been extensively studied globally, the specific determinants of these factors in relation to DR in Palestine are presently not well understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cross-sectional study included patients who underwent DR screening with a fundus camera (VersaCam <i>a</i>). The study included patients aged ≥18 with T2DM, excluding those with other types of diabetes or a history of malignancies. Univariable and multivariable logistic regressions were used to identify factors associated with DR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1163 patients with T2DM were included in this study. Of these, 211 (18.1%) patients were classified in the DR group, 761 (65.4%) in the no DR group and 191 (16.4%) were ungradable. Among the included patients, 434 (37.3%) were male. A secondary level of education or higher and a BMI ≥30 kg/m<sup>2</sup>, compared with <25 kg/m<sup>2</sup>, were independently and inversely associated with DR, with odds ratios (ORs) of 0.46 (<i>p</i> < 0.001) and 0.58 (<i>p</i> = 0.046), respectively. A 5-year increase in the duration of T2DM correlated with 45% higher odds of having DR (<i>p</i> < 0.001). Patients with DR were more likely to have HbA1c >7%, be physically inactive and use insulin, with ORs of 1.63 (<i>p</i> = 0.02), 2.05 (<i>p</i> < 0.001) and 1.53 (<i>p</i> = 0.03), respectively. Age, gender, occupational status, hypertension and hyperlipidaemia were not independent predictors of DR (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Longer duration of T2DM, HbA1c >7%, physical inactivity and insulin use were all independently associated with the presence of DR. Furthermore, a secondary or higher educational level and obesity demonstrated independent and inverse associations with the development of DR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.494","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Metabolic Responses to High-Fat Feeding and Chronic Psychological Stress Combination 高脂肪喂养与慢性心理压力相结合的代谢反应

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-06-12 DOI: 10.1002/edm2.487

Marzieh Nemati, Fatemeh Rostamkhani, Roxana Karbaschi, Homeira Zardooz

Introduction

High-fat diet (HFD) consumption and being exposed to daily psychological stress, common environmental factors in modern lifestyle, play an important role on metabolic disorders such as glucose homeostasis impairment. The aim of this study was to investigate the effects of high-fat diet (HFD) and psychological stress combination on metabolic response to chronic psychological stress in male rats.

Method

Male Wistar rats were divided into HFD, and normal diet (ND) groups and then into stress and nonstress subgroups. The diets were applied for 5 weeks, and psychological stress was induced for 7 consecutive days. Then, blood samples were taken to measure glucose, insulin, free fatty acids (FFA), and leptin and corticosterone concentrations. Subsequently, glucose-stimulated insulin release from pancreatic isolated islets was assessed.

Results

HFD did not significantly change fasting plasma glucose, insulin and corticosterone levels, whereas increased plasma leptin (7.05 ± 0.33) and FFA (p < 0.01) levels and impaired glucose tolerance. Additionally, HFD and stress combination induced more profound glucose intolerance associated with increased plasma corticosterone (p < 0.01) and leptin (8.63 ± 0.38) levels. However, insulin secretion from isolated islets did not change in the presence of high-fat diet and/or stress.

Conclusion

HFD should be considered as an intensified factor of metabolic impairments caused by chronic psychological stress.

导言高脂饮食（HFD）摄入和日常心理应激是现代生活方式中常见的环境因素，对代谢紊乱（如糖稳态受损）起着重要作用。本研究旨在探讨高脂饮食（HFD）和心理应激联合作用对雄性大鼠慢性心理应激代谢反应的影响：方法：将雄性 Wistar 大鼠分为高脂饮食组和正常饮食组（ND），再分为应激亚组和非应激亚组。两种饮食均连续使用 5 周，并连续 7 天诱导心理应激。然后采集血样测量葡萄糖、胰岛素、游离脂肪酸、瘦素和皮质酮的浓度。随后，评估葡萄糖刺激胰腺离体胰岛释放胰岛素的情况：结果：HFD 没有明显改变空腹血浆葡萄糖、胰岛素和皮质酮的水平，但增加了血浆瘦素（7.05 ± 0.33）和 FFA（p 结论：HFD 应被视为胰岛素的一种刺激剂：高频分解代谢应被视为慢性心理压力导致代谢损伤的强化因素。

{"title":"Metabolic Responses to High-Fat Feeding and Chronic Psychological Stress Combination","authors":"Marzieh Nemati, Fatemeh Rostamkhani, Roxana Karbaschi, Homeira Zardooz","doi":"10.1002/edm2.487","DOIUrl":"10.1002/edm2.487","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>High-fat diet (HFD) consumption and being exposed to daily psychological stress, common environmental factors in modern lifestyle, play an important role on metabolic disorders such as glucose homeostasis impairment. The aim of this study was to investigate the effects of high-fat diet (HFD) and psychological stress combination on metabolic response to chronic psychological stress in male rats.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Male Wistar rats were divided into HFD, and normal diet (ND) groups and then into stress and nonstress subgroups. The diets were applied for 5 weeks, and psychological stress was induced for 7 consecutive days. Then, blood samples were taken to measure glucose, insulin, free fatty acids (FFA), and leptin and corticosterone concentrations. Subsequently, glucose-stimulated insulin release from pancreatic isolated islets was assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>HFD did not significantly change fasting plasma glucose, insulin and corticosterone levels, whereas increased plasma leptin (7.05 ± 0.33) and FFA (<i>p</i> < 0.01) levels and impaired glucose tolerance. Additionally, HFD and stress combination induced more profound glucose intolerance associated with increased plasma corticosterone (<i>p</i> < 0.01) and leptin (8.63 ± 0.38) levels. However, insulin secretion from isolated islets did not change in the presence of high-fat diet and/or stress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HFD should be considered as an intensified factor of metabolic impairments caused by chronic psychological stress.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.487","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalence of Metabolic Syndrome and its Related Factors in Bangladeshi Adults: A Cross-Sectional Study 孟加拉成年人代谢综合征的患病率及其相关因素：一项横断面研究

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-06-09 DOI: 10.1002/edm2.491

Nurshad Ali, Abu Taher, Aporajita Das Trisha, Nusrat Jahan Koley, Khandaker Atkia Fariha, Farjana Islam

Objectives

Metabolic syndrome (MetS) is a group of medical conditions that elevate the chances of developing cardiovascular disease, stroke and Type 2 diabetes. This study aimed to determine the frequency and contributing risk factors of MetS in adults from Bangladesh.

Methods

In this cross-sectional study, 653 individuals (470 males and 183 females) were randomly selected to participate. Fasting blood samples were collected and analysed using standard methods to measure biochemical parameters. MetS was defined on the basis of NCEP-ATP III guidelines, and multivariate logistic regression analyses were conducted to identify factors associated with MetS.

Results

The prevalence of MetS was 19.7% in the healthy control group, 70.2% in the hypertensive group and 46.8% in the diabetic group. Overall, there was no significant difference in the prevalence of MetS between males (45%) and females (45.9%). The participants who had both hypertension and diabetes had the highest prevalence of MetS at 77.3%. Both males and females showed an increased trend in the prevalence of MetS and its components as they aged, except for WC in males (p < 0.01 for all cases). The 46–55 age group in males had a higher prevalence of MetS (68%), whereas the >55 age group in females had a prevalence of 73.9%. The most common component of MetS was low levels of HDL-C, which affected over 80% of the studied sample. According to the logistic regression analyses, age, BMI, hypertension and diabetes were significantly associated with MetS in both genders.

Conclusion

This study found a high prevalence of MetS in Bangladeshi adults. Several factors are significantly associated with the risk of MetS. It is crucial to consider the varying prevalence rates of MetS by age and gender as well as its different components while providing health guidance and support.

目的：代谢综合征（MetS）是一组会增加心血管疾病、中风和 2 型糖尿病发病几率的病症。本研究旨在确定代谢综合征在孟加拉国成年人中的发病率和诱发风险因素：在这项横断面研究中，随机抽取了 653 人（470 名男性和 183 名女性）参与研究。研究人员采集了空腹血样，并采用标准方法对生化指标进行了分析。根据 NCEP-ATP III 指南对 MetS 进行了定义，并进行了多变量逻辑回归分析，以确定与 MetS 相关的因素：结果：健康对照组的 MetS 患病率为 19.7%，高血压组为 70.2%，糖尿病组为 46.8%。总体而言，男性（45%）和女性（45.9%）的 MetS 患病率没有明显差异。同时患有高血压和糖尿病的参与者的 MetS 患病率最高，为 77.3%。随着年龄的增长，男性和女性的 MetS 及其组成部分的患病率都呈上升趋势，但男性的 WC（女性 55 岁年龄组的患病率为 73.9%）除外。MetS 中最常见的成分是高密度脂蛋白胆固醇水平低，影响了研究样本中超过 80% 的人。根据逻辑回归分析，年龄、体重指数、高血压和糖尿病与男女 MetS 均有显著相关性：本研究发现，孟加拉成年人的 MetS 患病率很高。结论：这项研究发现，孟加拉成年人的 MetS 患病率很高。在提供健康指导和支持时，必须考虑不同年龄和性别的 MetS 患病率及其不同组成部分。

{"title":"Prevalence of Metabolic Syndrome and its Related Factors in Bangladeshi Adults: A Cross-Sectional Study","authors":"Nurshad Ali, Abu Taher, Aporajita Das Trisha, Nusrat Jahan Koley, Khandaker Atkia Fariha, Farjana Islam","doi":"10.1002/edm2.491","DOIUrl":"10.1002/edm2.491","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Metabolic syndrome (MetS) is a group of medical conditions that elevate the chances of developing cardiovascular disease, stroke and Type 2 diabetes. This study aimed to determine the frequency and contributing risk factors of MetS in adults from Bangladesh.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional study, 653 individuals (470 males and 183 females) were randomly selected to participate. Fasting blood samples were collected and analysed using standard methods to measure biochemical parameters. MetS was defined on the basis of NCEP-ATP III guidelines, and multivariate logistic regression analyses were conducted to identify factors associated with MetS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of MetS was 19.7% in the healthy control group, 70.2% in the hypertensive group and 46.8% in the diabetic group. Overall, there was no significant difference in the prevalence of MetS between males (45%) and females (45.9%). The participants who had both hypertension and diabetes had the highest prevalence of MetS at 77.3%. Both males and females showed an increased trend in the prevalence of MetS and its components as they aged, except for WC in males (<i>p</i> < 0.01 for all cases). The 46–55 age group in males had a higher prevalence of MetS (68%), whereas the >55 age group in females had a prevalence of 73.9%. The most common component of MetS was low levels of HDL-C, which affected over 80% of the studied sample. According to the logistic regression analyses, age, BMI, hypertension and diabetes were significantly associated with MetS in both genders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study found a high prevalence of MetS in Bangladeshi adults. Several factors are significantly associated with the risk of MetS. It is crucial to consider the varying prevalence rates of MetS by age and gender as well as its different components while providing health guidance and support.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.491","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Markers of Fertility in Adolescents With Chronic Endocrinopathies at Transition From Paediatric to Adult Care 患有慢性内分泌疾病的青少年在从儿科护理向成人护理过渡时的生育能力指标。

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-06-07 DOI: 10.1002/edm2.493

Daniela Choukair, Janna Mittnacht, Markus Bettendorf

Objective

During the process of transition from paediatric to adult health care, counselling concerning fertility is an important issue and is based mainly on serum markers of gonadal function. Here, we analysed these markers in adolescents with various underlying endocrine diseases at the time of transition.

Methods

After reaching near adult height and late puberty (girls: bone age [BA] ≥14 years, and boys: BA ≥16 years), we assessed stages of puberty according to Tanner and measured testes or ovarian volumes and serum markers of gonadal function (anti-Mullerian hormone [AMH], inhibin B, 17β-estradiol, testosterone).

Results

One hundred and ten patients (56 females and 54 males) were included from May 2010 to March 2016 with multiple pituitary hormone deficiency (MPHD; n = 17), growth hormone deficiency (GHD; n = 35), Turner syndrome (TS; n = 27), short stature after being born small for gestational age (SGA; n = 20) and Klinefelter syndrome (KS; n = 11). Female and male adolescents exhibited mature secondary sexual characteristics. The levels of serum inhibin B and AMH were lower in TS and female MPHD than in GHD and SGA, each independently (p < 0.05). The levels of serum AMH were higher whereas serum inhibin B were lower in male MPHD and KS (p < 0.05). Ovary volumes were significantly smaller in patients with TS, and testicular volumes were smaller in patients with KS.

Conclusions

After current established treatments with sex steroids, the development of secondary sexual characteristics was mature. However, impaired markers of fertility have been identified in patients with TS, KS and MPHD, reflecting gonadal dysgenesis in TS and KS, but gonadal immaturity in MPHD as gonadal gonadotropin stimulation is lacking throughout development. Consequently, in patients with MPHD, these markers cannot reliably predict individual fertility, which warrants consideration and incorporation in future treatment concepts.

目的：在从儿科医疗向成人医疗过渡的过程中，有关生育的咨询是一个重要问题，其主要依据是性腺功能的血清标志物。在此，我们对患有各种潜在内分泌疾病的青少年在过渡时期的这些指标进行了分析：方法：在身高接近成人且青春期晚期（女孩：骨龄[BA]≥14 岁，男孩：骨龄[BA]≥16 岁）后，我们根据坦纳标准评估青春期阶段，并测量睾丸或卵巢体积和性腺功能血清标志物（抗穆勒氏管激素[AMH]、抑制素 B、17β-雌二醇、睾酮）：2010年5月至2016年3月期间，110名患者（56名女性和54名男性）患有多发性垂体激素缺乏症（MPHD，17人）、生长激素缺乏症（GHD，35人）、特纳综合征（TS，27人）、小于胎龄儿出生后身材矮小（SGA，20人）和克莱恩费尔特综合征（KS，11人）。男女青少年均表现出成熟的第二性征。TS和女性MPHD的血清抑制素B和AMH水平低于GHD和SGA，各自独立（p 结论：TS和女性MPHD的血清抑制素B和AMH水平低于GHD和SGA：经过目前已确定的性类固醇治疗后，第二性征发育成熟。然而，在 TS、KS 和 MPHD 患者中发现了生育能力受损的标志物，这反映出 TS 和 KS 患者的性腺发育不良，而 MPHD 患者的性腺发育不成熟，因为在整个发育过程中缺乏促性腺激素的刺激。因此，这些标志物不能可靠地预测MPHD患者的生育能力，这值得考虑并纳入未来的治疗理念中。

{"title":"Markers of Fertility in Adolescents With Chronic Endocrinopathies at Transition From Paediatric to Adult Care","authors":"Daniela Choukair, Janna Mittnacht, Markus Bettendorf","doi":"10.1002/edm2.493","DOIUrl":"10.1002/edm2.493","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>During the process of transition from paediatric to adult health care, counselling concerning fertility is an important issue and is based mainly on serum markers of gonadal function. Here, we analysed these markers in adolescents with various underlying endocrine diseases at the time of transition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>After reaching near adult height and late puberty (girls: bone age [BA] ≥14 years, and boys: BA ≥16 years), we assessed stages of puberty according to Tanner and measured testes or ovarian volumes and serum markers of gonadal function (anti-Mullerian hormone [AMH], inhibin B, 17β-estradiol, testosterone).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred and ten patients (56 females and 54 males) were included from May 2010 to March 2016 with multiple pituitary hormone deficiency (MPHD; <i>n</i> = 17), growth hormone deficiency (GHD; <i>n</i> = 35), Turner syndrome (TS; <i>n</i> = 27), short stature after being born small for gestational age (SGA; <i>n</i> = 20) and Klinefelter syndrome (KS; <i>n</i> = 11). Female and male adolescents exhibited mature secondary sexual characteristics. The levels of serum inhibin B and AMH were lower in TS and female MPHD than in GHD and SGA, each independently (<i>p</i> < 0.05). The levels of serum AMH were higher whereas serum inhibin B were lower in male MPHD and KS (<i>p</i> < 0.05). Ovary volumes were significantly smaller in patients with TS, and testicular volumes were smaller in patients with KS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>After current established treatments with sex steroids, the development of secondary sexual characteristics was mature. However, impaired markers of fertility have been identified in patients with TS, KS and MPHD, reflecting gonadal dysgenesis in TS and KS, but gonadal immaturity in MPHD as gonadal gonadotropin stimulation is lacking throughout development. Consequently, in patients with MPHD, these markers cannot reliably predict individual fertility, which warrants consideration and incorporation in future treatment concepts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.493","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Insulin Inertia Among People With Type 2 Diabetes Mellitus in Qatar: The INERT-Q Study 卡塔尔 2 型糖尿病患者的胰岛素惰性：INERT-Q 研究。

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-06-06 DOI: 10.1002/edm2.495

Mohammed Bashir, Noora Al Thani, Abeer Khalid, Obada Khalil, Zaina Alamer, Mohammed Khair Hamad, Gowri Karuppasamy, Mohammed Abufaeid, Mutwakil Elbidairi, Dhabia Al-Mohnnadi, Tarik Elhadd, Mahmoud Zirie

Background

Achieving and maintaining adequate glycaemic control is critical to reduce diabetes-related complications. Therapeutic inertia is one of the leading causes of suboptimal glycaemic control.

Aim

To assess the degree of inertia in insulin initiation and intensification in people with Type 2 diabetes mellitus (DM-2).

Methods

We performed a retrospective longitudinal cohort study and followed DM-2 2 years before and 2 years after the start of insulin. The primary outcome was the proportion of patients who achieved glycaemic targets (HBA1c ≤ 7.5%) at 6th month, 1st year and 2nd year.

Results

We included 374 predominantly male subjects (62%). The mean age was 55.3 ± 11.3 years, the mean duration of DM-2 was 12.0 ± 7.3 years, 64.4% were obese, 47.6% had a microvascular disease, and 24.3% had a macrovascular disease. The mean HBA1c at −2nd year and −1st year was 9.2 ± 2.1% and 9.3 ± 2.0%, respectively. The mean HbA1C at the time of insulin initiation was 10.4 ± 2.1%. The mean HBA1c at 6th month, 12th month and 2nd year was 8.5 ± 1.8%, 8.4 ± 1.8% and 8.5 ± 1.7%, respectively. The proportion of subjects who achieved HBA1c targets at 6th month, 12th month and 2nd year was 32.9%, 31.0% and 32.9%, respectively. Multivariate logistic regression analysis showed that achieving HBA1c targets at 6th month and 1st year increases the odds of achieving HBA1c targets at 2nd year (OR 4.87 [2.4–9.6] p < 0.001) and (OR 6.2 [3.2–12.0], p < 0.001), respectively.

Conclusion

In people with DM-2, there was an alarming delay in starting and titrating insulin. The reduction in HBA1c plateaued at 6th month. Earlier initiation and intensification of insulin therapy are critical to achieving glycaemic targets. More studies are needed to examine the causes of therapeutic inertia from physicians', patients' and systems' points of view.

背景：实现并维持适当的血糖控制对减少糖尿病相关并发症至关重要。目的：评估 2 型糖尿病患者（DM-2）在开始和加强使用胰岛素时的惰性程度：我们进行了一项回顾性纵向队列研究，对开始使用胰岛素前 2 年和开始使用胰岛素后 2 年的 DM-2 患者进行了跟踪调查。主要结果是在第 6 个月、第 1 年和第 2 年达到血糖目标（HBA1c ≤ 7.5%）的患者比例：我们共纳入了 374 名男性患者（占 62%）。平均年龄为 55.3 ± 11.3 岁，DM-2 平均病程为 12.0 ± 7.3 年，64.4% 为肥胖，47.6% 有微血管疾病，24.3% 有大血管疾病。第 2 年和第 1 年的平均 HBA1c 分别为 9.2 ± 2.1% 和 9.3 ± 2.0%。开始使用胰岛素时的平均 HbA1C 为 10.4 ± 2.1%。第 6 个月、第 12 个月和第 2 年的平均 HBA1c 分别为 8.5 ± 1.8%、8.4 ± 1.8% 和 8.5 ± 1.7%。第 6 个月、第 12 个月和第 2 年达到 HBA1c 目标的受试者比例分别为 32.9%、31.0% 和 32.9%。多变量逻辑回归分析表明，第6个月和第1年达到HBA1c目标会增加第2年达到HBA1c目标的几率（OR 4.87 [2.4-9.6] p 结论）：在DM-2患者中，胰岛素起始和滴定的延迟令人担忧。HBA1c 的降低在第 6 个月时趋于稳定。尽早开始和加强胰岛素治疗对实现血糖目标至关重要。需要进行更多的研究，从医生、患者和系统的角度研究治疗惰性的原因。

{"title":"Insulin Inertia Among People With Type 2 Diabetes Mellitus in Qatar: The INERT-Q Study","authors":"Mohammed Bashir, Noora Al Thani, Abeer Khalid, Obada Khalil, Zaina Alamer, Mohammed Khair Hamad, Gowri Karuppasamy, Mohammed Abufaeid, Mutwakil Elbidairi, Dhabia Al-Mohnnadi, Tarik Elhadd, Mahmoud Zirie","doi":"10.1002/edm2.495","DOIUrl":"10.1002/edm2.495","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Achieving and maintaining adequate glycaemic control is critical to reduce diabetes-related complications. Therapeutic inertia is one of the leading causes of suboptimal glycaemic control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To assess the degree of inertia in insulin initiation and intensification in people with Type 2 diabetes mellitus (DM-2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective longitudinal cohort study and followed DM-2 2 years before and 2 years after the start of insulin. The primary outcome was the proportion of patients who achieved glycaemic targets (HBA1c ≤ 7.5%) at 6th month, 1st year and 2nd year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 374 predominantly male subjects (62%). The mean age was 55.3 ± 11.3 years, the mean duration of DM-2 was 12.0 ± 7.3 years, 64.4% were obese, 47.6% had a microvascular disease, and 24.3% had a macrovascular disease. The mean HBA1c at −2nd year and −1st year was 9.2 ± 2.1% and 9.3 ± 2.0%, respectively. The mean HbA1C at the time of insulin initiation was 10.4 ± 2.1%. The mean HBA1c at 6th month, 12th month and 2nd year was 8.5 ± 1.8%, 8.4 ± 1.8% and 8.5 ± 1.7%, respectively. The proportion of subjects who achieved HBA1c targets at 6th month, 12th month and 2nd year was 32.9%, 31.0% and 32.9%, respectively. Multivariate logistic regression analysis showed that achieving HBA1c targets at 6th month and 1st year increases the odds of achieving HBA1c targets at 2nd year (OR 4.87 [2.4–9.6] <i>p</i> < 0.001) and (OR 6.2 [3.2–12.0], <i>p</i> < 0.001), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In people with DM-2, there was an alarming delay in starting and titrating insulin. The reduction in HBA1c plateaued at 6th month. Earlier initiation and intensification of insulin therapy are critical to achieving glycaemic targets. More studies are needed to examine the causes of therapeutic inertia from physicians', patients' and systems' points of view.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.495","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association Between Insulin Resistance Indices and Liver Function Parameters Among Women With Polycystic Ovary Syndrome 多囊卵巢综合征妇女的胰岛素抵抗指数与肝功能参数之间的关系

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-05-20 DOI: 10.1002/edm2.490

Marzieh Saei Ghare Naz, Maryam Mousavi, Faezeh Firouzi, Amir Abbas Momenan, Fereidoun Azizi, Fahimeh Ramezani Tehrani

Objective

This study aimed to investigate whether polycystic ovary syndrome (PCOS) status changes the association between insulin resistance (IR) indices and liver function parameters among women.

Methods

This is a cross-sectional, population-based study. We selected 1101 subjects aged ≥20 years from participants of Tehran Lipid and Glucose Study (TLGS). All of them had known the status of PCOS, and all variables were related to the IR indices and liver function parameters. The main outcome measures were TG/HDL-C and triglyceride-glucose (TyG) and liver function parameters (hepatic steatosis index [HSI], alanine transaminase [ALT] and aspartate transaminase [AST]).

Result

In the present study, there was no significant difference between the PCOS and the non-PCOS regarding the presence of liver function abnormalities. A model adjusted by age and BMI showed that the upper tertile of TyG index was positively associated with high AST (OR = 3.04 [95% CI: 1.20–7.68], p < 0.05), high ALT (4.76 [3.07–7.36], p < 0.05) and high HSI (8.44 [1.82–39.17], p < 0.05). Although the history of diabetes had a positive impact on elevated AST (1.66 [1.15, 2.40], p < 0.05), the third tertile of TG/HDL-C was associated with increased odds of elevated ALT (3.35 [2.21–5.06]) and HSI (6.55 [1.17–36.46]), whereas the second tertile of TG/HDL-C (OR = 2.65, CI 95%: 1.74–4.03) was also positively associated with elevated ALT. PCOS had no significant association with elevated liver function tests.

Conclusion

The highest tertile of TyG index and the TG/HDL-C ratio as a surrogate of IR might play a role in detecting abnormalities of liver function parameters among women. However, PCOS status cannot change the association between IR and liver dysfunction.

目的本研究旨在探讨多囊卵巢综合征（PCOS）是否会改变女性胰岛素抵抗（IR）指数与肝功能参数之间的关系：这是一项基于人群的横断面研究。我们从德黑兰血脂和血糖研究（TLGS）的参与者中选取了 1101 名年龄≥20 岁的受试者。所有受试者都知道自己患有多囊卵巢综合症，所有变量都与红外指数和肝功能参数有关。主要结果指标为 TG/HDL-C、甘油三酯-葡萄糖（TyG）和肝功能参数（肝脏脂肪变性指数[HSI]、丙氨酸转氨酶[ALT]和天冬氨酸转氨酶[AST]）：结果：在本研究中，多囊卵巢综合症患者与非多囊卵巢综合症患者在肝功能异常方面没有明显差异。经年龄和体重指数调整后的模型显示，TyG 指数的最高三分位数与谷草转氨酶高呈正相关（OR = 3.04 [95% CI: 1.20-7.68], p 结论：TyG 指数的最高三分位数与谷草转氨酶高呈正相关（OR = 3.04 [95% CI: 1.20-7.68], p 结论）：TyG指数的最高三分位数和TG/HDL-C比值作为IR的替代指标，可能在检测女性肝功能参数异常方面发挥作用。然而，多囊卵巢综合症并不能改变IR与肝功能异常之间的关联。

{"title":"Association Between Insulin Resistance Indices and Liver Function Parameters Among Women With Polycystic Ovary Syndrome","authors":"Marzieh Saei Ghare Naz, Maryam Mousavi, Faezeh Firouzi, Amir Abbas Momenan, Fereidoun Azizi, Fahimeh Ramezani Tehrani","doi":"10.1002/edm2.490","DOIUrl":"10.1002/edm2.490","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to investigate whether polycystic ovary syndrome (PCOS) status changes the association between insulin resistance (IR) indices and liver function parameters among women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a cross-sectional, population-based study. We selected 1101 subjects aged ≥20 years from participants of Tehran Lipid and Glucose Study (TLGS). All of them had known the status of PCOS, and all variables were related to the IR indices and liver function parameters. The main outcome measures were TG/HDL-C and triglyceride-glucose (TyG) and liver function parameters (hepatic steatosis index [HSI], alanine transaminase [ALT] and aspartate transaminase [AST]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>In the present study, there was no significant difference between the PCOS and the non-PCOS regarding the presence of liver function abnormalities. A model adjusted by age and BMI showed that the upper tertile of TyG index was positively associated with high AST (OR = 3.04 [95% CI: 1.20–7.68], <i>p</i> < 0.05), high ALT (4.76 [3.07–7.36], <i>p</i> < 0.05) and high HSI (8.44 [1.82–39.17], <i>p</i> < 0.05). Although the history of diabetes had a positive impact on elevated AST (1.66 [1.15, 2.40], <i>p</i> < 0.05), the third tertile of TG/HDL-C was associated with increased odds of elevated ALT (3.35 [2.21–5.06]) and HSI (6.55 [1.17–36.46]), whereas the second tertile of TG/HDL-C (OR = 2.65, CI 95%: 1.74–4.03) was also positively associated with elevated ALT. PCOS had no significant association with elevated liver function tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The highest tertile of TyG index and the TG/HDL-C ratio as a surrogate of IR might play a role in detecting abnormalities of liver function parameters among women. However, PCOS status cannot change the association between IR and liver dysfunction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.490","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Metabolomics Signature in Prediabetes and Diabetes: Insights From Tandem Mass Spectrometry Analysis 糖尿病前期和糖尿病的代谢组学特征：串联质谱分析的启示。

Q3 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism

Pub Date : 2024-05-13 DOI: 10.1002/edm2.484

Saad Ayyal Jabbar Al-Rikabi, Ali Etemadi, Maher Mohammed Morad, Azin Nowrouzi, Ghodarollah Shayriyar Panahi, Mozhgan Mondeali, Mahsa Toorani-ghazvini, Ensieh Nasli-Esfahani, Farideh Razi, Fatemeh Bandarian

Objective

This study investigates the metabolic differences between normal, prediabetic and diabetic patients with good and poor glycaemic control (GGC and PGC).

Design

In this study, 1102 individuals were included, and 50 metabolites were analysed using tandem mass spectrometry. The diabetes diagnosis and treatment standards of the American Diabetes Association (ADA) were used to classify patients.

Methods

The nearest neighbour method was used to match controls and cases in each group on the basis of age, sex and BMI. Factor analysis was used to reduce the number of variables and find influential underlying factors. Finally, Pearson's correlation coefficient was used to check the correlation between both glucose and HbAc1 as independent factors with binary classes.

Results

Amino acids such as glycine, serine and proline, and acylcarnitines (AcylCs) such as C16 and C18 showed significant differences between the prediabetes and normal groups. Additionally, several metabolites, including C0, C5, C8 and C16, showed significant differences between the diabetes and normal groups. Moreover, the study found that several metabolites significantly differed between the GGC and PGC diabetes groups, such as C2, C6, C10, C16 and C18. The correlation analysis revealed that glucose and HbA1c levels significantly correlated with several metabolites, including glycine, serine and C16, in both the prediabetes and diabetes groups. Additionally, the correlation analysis showed that HbA1c significantly correlated with several metabolites, such as C2, C5 and C18, in the controlled and uncontrolled diabetes groups.

Conclusions

These findings could help identify new biomarkers or underlying markers for the early detection and management of diabetes.

研究目的本研究探讨了正常人、糖尿病前期患者以及血糖控制良好和血糖控制不佳的糖尿病患者（GGC 和 PGC）之间的代谢差异：本研究共纳入 1102 人，使用串联质谱法分析了 50 种代谢物。采用美国糖尿病协会（ADA）的糖尿病诊断和治疗标准对患者进行分类：根据年龄、性别和体重指数，采用近邻法将每组中的对照组和病例进行匹配。采用因素分析法减少变量数量，找出有影响的潜在因素。最后，使用皮尔逊相关系数检验葡萄糖和 HbAc1 这两个独立因素与二元类之间的相关性：结果：甘氨酸、丝氨酸和脯氨酸等氨基酸以及 C16 和 C18 等酰基肉碱（AcylCs）在糖尿病前期组和正常组之间存在显著差异。此外，包括 C0、C5、C8 和 C16 在内的几种代谢物在糖尿病组和正常组之间存在显著差异。研究还发现，GGC 和 PGC 糖尿病组之间有几种代谢物存在显著差异，如 C2、C6、C10、C16 和 C18。相关性分析表明，在糖尿病前期组和糖尿病组中，葡萄糖和 HbA1c 水平与几种代谢物（包括甘氨酸、丝氨酸和 C16）有明显的相关性。此外，相关性分析表明，在糖尿病控制组和未控制组中，HbA1c 与 C2、C5 和 C18 等几种代谢物有明显的相关性：这些发现有助于确定新的生物标志物或潜在标志物，用于糖尿病的早期检测和管理。

{"title":"Metabolomics Signature in Prediabetes and Diabetes: Insights From Tandem Mass Spectrometry Analysis","authors":"Saad Ayyal Jabbar Al-Rikabi, Ali Etemadi, Maher Mohammed Morad, Azin Nowrouzi, Ghodarollah Shayriyar Panahi, Mozhgan Mondeali, Mahsa Toorani-ghazvini, Ensieh Nasli-Esfahani, Farideh Razi, Fatemeh Bandarian","doi":"10.1002/edm2.484","DOIUrl":"10.1002/edm2.484","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study investigates the metabolic differences between normal, prediabetic and diabetic patients with good and poor glycaemic control (GGC and PGC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>In this study, 1102 individuals were included, and 50 metabolites were analysed using tandem mass spectrometry. The diabetes diagnosis and treatment standards of the American Diabetes Association (ADA) were used to classify patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The nearest neighbour method was used to match controls and cases in each group on the basis of age, sex and BMI. Factor analysis was used to reduce the number of variables and find influential underlying factors. Finally, Pearson's correlation coefficient was used to check the correlation between both glucose and HbAc1 as independent factors with binary classes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Amino acids such as glycine, serine and proline, and acylcarnitines (AcylCs) such as C16 and C18 showed significant differences between the prediabetes and normal groups. Additionally, several metabolites, including C0, C5, C8 and C16, showed significant differences between the diabetes and normal groups. Moreover, the study found that several metabolites significantly differed between the GGC and PGC diabetes groups, such as C2, C6, C10, C16 and C18. The correlation analysis revealed that glucose and HbA1c levels significantly correlated with several metabolites, including glycine, serine and C16, in both the prediabetes and diabetes groups. Additionally, the correlation analysis showed that HbA1c significantly correlated with several metabolites, such as C2, C5 and C18, in the controlled and uncontrolled diabetes groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings could help identify new biomarkers or underlying markers for the early detection and management of diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"7 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.484","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0